Provider Demographics
NPI:1639778814
Name:CIGNO FAMILY DENTAL S.C.
Entity Type:Organization
Organization Name:CIGNO FAMILY DENTAL S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:G
Authorized Official - Last Name:CIGNO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-988-6433
Mailing Address - Street 1:7940 W LAYTON AVE
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53220-3711
Mailing Address - Country:US
Mailing Address - Phone:414-988-6433
Mailing Address - Fax:414-988-6074
Practice Address - Street 1:7940 W LAYTON AVE
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:WI
Practice Address - Zip Code:53220-3711
Practice Address - Country:US
Practice Address - Phone:414-988-6433
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-20
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1265543284Medicaid